Korre Rogicha’s farming economy is sustained by the two rainy annual seasons. The big ‘kiremt’ rains normally run from June to September, producing the main harvest. The small ‘belg’ rains, from February to April or May, produce a smaller harvest helps farmers cope during the lean season.

But this year, the small rains are late. Ms. Erbo’s family had hoped the corn harvest would tide them over until the kiremt rains, but the harvest has not come in. The delayed rains are compounding their already precarious situation; the 2011 drought left their household without food reserves.

“There was no harvest last year,” she said. “We have planted again this year, but the plants are thin and we don’t know when they will mature.”

Life-saving health extension workers

Ms. Erbo tries to supplement the family’s income by working as a day labourer, but work is scarce and her employers are often late with their payments. As a result, her children have been losing weight.

Her 18-month-old daughter Shegitu Tule became severely malnourished. “When I saw her so sick, I didn’t know what to do. I thought she would die,” Ms. Erbo said.

She brought Shegitu to the village health post, where the health extension workers, who are trained with support from UNICEF, provide outpatient therapeutic feeding for malnourished children.

Worke Bati Julati is one of two health extension workers at the Korre Rogicha Health Post. She is one of 34,000 government salaried health extension workers who have been deployed to 15,000 village health posts throughout the country to provide an integrated package of health, nutrition, sanitation and hygiene services.

“Shegitu was a very sick child when she came to me,” Ms. Julati said. Shegitu was placed on a regimen of ready-to-use therapeutic foods (RUTF). One week later, the little girl has greatly improved.

Building resilience in rural areas

Ms. Julati said that, prior to the start of the outpatient therapeutic feeding programme, malnutrition was rife in Korre Rogicha and a lot of children died. But today, children are surviving.

“We started providing RUTF here in 2009,” she said. “Before that, families would have to go all the way to Fajee Gole health centre [two hours away on foot], and a lot of children died. But after the setting up of the health post, there has been a lot of change.”

It was part of a strategy to build resilience among rural residents, who make up more than 80 per cent of the Ethiopian population.

Also central to the strategy are women volunteers selected by the community to monitoring the health of nearby families. They have been trained to identify sick and malnourished children and to refer them to the health post for evaluation and treatment. This has ensured early referral, thereby preventing severe malnutrition, stunting and other adverse outcomes.

“In the past the children were in a very bad state,” Ms. Julati. “But now there is great improvement. And the reason is that every week they get the RUTF – it is so effective that they are no longer dying. Over the past four years, a lot of children’s lives have been saved.”

Health extension workers also provide an integrated package of services including vaccinations against illnesses like measles and pneumonia; growth monitoring for children under age 2; vitamin A supplementation; and deworming tablets. They also promote hand-washing with soap and exclusive breastfeeding for the first six months of life.

Working to prevent disaster

Yet with the threat of another drought looming, the number of moderately malnourished children in Korre Rogicha is increasing. “I am afraid that there will be more severe malnutrition cases,” said Ms. Julati.

Health workers, together with government programmes and partners, are working to prevent this from happening.

The number of centres providing outpatient therapeutic services has increased from 500 in 2008 to over 10,000 today. This increase in capacity – along with the Productive Safety Net Programme (PSNP), the government’s food- or cash-for-work programme for food-insecure districts – is ensuring that vulnerable communities are able to handle adversity.

The government and its development partners are also ensuring farmers will be able to replenish their seeds for the kiremt growing season.

Meanwhile, Ms. Erbo is relieved that her daughter is recovering. “My wish is for the children to survive and grow up,” she said.